ADHD at School

Services for Twice Exceptional Kids

I have a 4 year old son who is intellectually gifted, but has also been diagnosed with ADHD combined type. He also has obstructive sleep apnea which we are in the process of treating (tonsiladenoectomy and CPAP) which can either be causing or be coexisting with the ADHD symptoms.

We had him tested by the school district in January before we had his diagnosis and despite clinical indication of ADHD on the Achenbach and behavioral issues in his preschool setting, the school district dismissed him because his problems were “not affecting academics.” We were also told that he wouldn’t be able to do so well on his IQ test and Educational eval if he truly had ADHD. What a bunch of nonsense. I fought hard, but ultimately, the school would not classify him. All I asked for was SEIT support for behavior and they gave him nothing all based on his test scores.

In the meantime, I have privately paid for him to be in a regular ed preschool class taught by a special ed teacher. It is a developmental preschool, and although he is doing better there, he is still exhibiting the same behaviors (i.e., hyperactivity, impulsivity, difficulty with transitions, trouble maintaining personal space, following directions, too loud, too verbal). I also have gone to a parent trainer and have had him seen for play therapy at my own expense. I understand this is my responsibility as a parent, but I am worried that it isn’t enough support. He continues to demonstrate significant behaviors even in this setting with this much support.

We had a neurological evaluation done over the summer. The neurologist said that he comes out with a clear ADHD diagnosis with the rating scales, but that with sleep apnea, it could also be the cause. She gave us a diagnosis to help with school.

We are requesting a new evaluation and will include an OT eval to have sensory evaluated. I don’t have any sensory concerns, but the psychologist at his preschool said it wouldn’t hurt to check. They will also do another classroom observation and rating scales.

At this point, what else could I do to get the school district to give him services. I am afraid they will make it all about his test scores again and not his behavior. I fear he will be set up to fail in Kindergarten next year. He has already internalized that he is “the laughingstock of my classroom” and the “baddest one in the class.”

I am not ready to medicate him yet at 4, especially since we are still treating the sleep issues. Any advice as to how to get the school to look beyond his test scores?

You can apply for ssi for assistance and also try a non stimulant first. My son is 4 years old and is on medication. I had to make the call for him to be switched over to a stimulant versus a non stimulant. The non stimulant wasnt working as well as the stimulant. It takes a lot of work to go from changing meds and finding the right one. You have to go in knowing that you will probably be trying this one then upping the dose, then going to another medication.

Both my boys are twice-exceptional. Intelligent with ADHD. I have had numerous conflicts with their school system and have learned a lot. In my opinion, your best resource is http://www.wrightslaw.com. It is a special education law website that can answer most any question you have. He has several books he sells on the site. Get them all.

First, Federal and State Law states the school can not require you to medicate your child for his ADHD. Specifically the Federal Law states, “The State educational agency shall prohibit State and local educational agency personnel from requiring a child to obtain a prescription for a substance covered by the Controlled Substances Act as a condition of attending school, receiving an evaluation…, or receiving services under this title.” Therefore, if you request in writing that he be evaluated then they have to evaluated him regardless of medication status.

Next, Peter Wright (of wrightslaw.com) states in his book, All About IEPs, “If your child’s behavior prevents him or other children from learning, the IEP should include goals to address these problem behaviors. The team should consider positive behavioral interventions and supports (PBIS) and other strategies to change the child’s behavior. Research demonstrates that positive behavioral interventions and supports are effective in dealing with behavior that is dangerous, disruptive, impedes learning, and leads to social exclusion.” Peter Wright describes this as a “functional behavior assessment.”

If he has a diagnosis of ADHD then as long as it is impeding his ability to learn in the classroom then it is considered a disability under Federal Law under Other Health Impairment. It specifically lists ADHD under this heading.

We started giving our oldest son medication in 3rd grade, not due to his grades (since he made straight As), but due to his self-esteem. Our youngest was already developing self-esteem issues in 1st grade which is when we started him. Self-esteem is so hard to repair. Make sure your son has plenty of opportunities to show off his strengths and intelligence and he is praised for these things, in school and at home. The school should address his strengths as well as his weaknesses. He needs to feel success.

I wonder if you can have the doctor that diagnosed the ADHD write a letter or add to the diagnosis report to reference the fact that the child is gifted, but he still struggles with ADHD, that his neurology is such that he has a high IQ, but also struggles with attention, impulsivity, planning, organization, etc. The school board obviously needs to be educated on twice exceptional students.

I also have a twice exceptional child. My son is 15 with a General Ability Index of 148, but a school GPA that falls each year because of missing assignments. I was denied a 504 plan because of his intelligence, and am expecting to be denied a gifted IEP because of his grades.
The counselor suggested an informal meeting with his teachers to see if they may be willing to help him “under the radar” with some of the items I hoped to get in the 504 plan, such as an additional day to turn in assignments without penalty if he forgets them, or a gentle reminder of assignments. The meeting is tomorrow, and I hope I can get the teachers to help.

My now 15-year old daughter was identical to your 4-year old. I won’t set false expectations, it continues to be exhausting, but we have had many moments of great accomplishments. My older daughter takes three times my time and energy as her younger sister (which I feel guilty about of course), and sometimes I am so resentful of being exhausted all the time, but what brilliance and creativity she has. (Note: Our school system has honors classes plus special classes for gifted kids that are held when the other kids have “resource period”. My daughter is in the honors classes, but the free structure of the gifted classes did not work for her.)

One idea: Bring books and articles about the ADHD and Gifted combination. Offer to provide books to the teacher resource library. Offer to sponsor a seminar. (The Kirk Martin - Celebrate Calm seminars are great.) In other words, make it clear that your school system needs to be educated about the needs of these children. It’s not enough for a kid to get by, every kid should thrive.

Another idea: Find out if any highly respected teacher or admin in your school system is themselves ADHD. That person can be your best advocate. Gifted ADHD students have so much to offer, but they do have special needs. The outstanding teachers that understand can be your best advocate. Also, find out if there are other parents with gifted ADHD kids. Did you know that Thomas Edison’s mother pulled him out of school and taught him at home because he was so discouraged about being is trouble so often? Einstein had issues in school also.

You don’t say where you live. It is so sad to hear about how some school districts are so uneducated about ADD/ADHD. Even the school districts like mine that try hard, require you to push and push and push. My daughter was always a high A student, but only because we fought for teachers to work with us regarding her emotional and behavioral problems. My husband and I are convinced that she could have easily been one of those “lost kids”. At one meeting my husband even said “Does my daughter have to fail before we can get her the help that she needs?”

My school never did an IEP or 504 plan, but we did do a child study and that was the correct solution for my daughter. Every year, middle school and high school included, my husband and I met with the teaching team (even in elementary school that included PE teacher, music teach, art teacher, in addition to her main teacher) at the beginning of the year to discuss my daughter’s history and strategies that worked with her. We then met with the team once a quarter, more if needed, to talk about what was and wasn’t working.

We made it very clear that we do work with her on rules and behavior and not being rude, etc, etc, but constantly reminded them that her brain doesn’t work like other peoples. She does face consequences for behavior, but no one can constantly be in trouble and have any hope for themselves. It is essential to find ways for the child to shine and succeed.

VERY IMPORTANT NOTE: ANXIETY is a huge issue for ADHD kids and every time they get in trouble despite their intention to have a good day, they get anxious about the next day. Ironically anxiety causes the behavior to get worse so it is a vicious cycle. Your son needs the opportunity to be in a group where his talents are recognized and rewarded while his challenges are gently managed. Ironically, in our case, the private kindergarten our daughter was going to did not work for her (the Montessori structure was too open ended for her.) Instead, her kindergarten and 1st grade teachers at our public school were fantastic and she thrived.

We did not begin medication for our daughter until 4th grade. I wish we had done it sooner. She still suffers from the emotional scars of having zero friends her 4th grade year. While kids were friendly enough at school, no girls invited her to play or to parties. She was too exhausting. It was especially hard since she was a girl and had reached the age where play dates with boys were “weird”.

If he is going to a public school request at ‘case study’ be done to evaluate him for a IEP. Contact Special Ed Services with an email that says you are the parents and are requesting a ‘case study’ on your child. If you have a diagnosis of ADHD make sure you have a documented copy in his file at school. They are required by law to ‘find’ children with disabilities (ADHD is a disability according to our district) - it is called the ‘Child Find Law’. We had the same exact problem with our son. He was falling through the cracks and suffering horribly because he was not getting services he needed to cope with school. He has always tested very high and had great grades so they were not worried about him. This year he has an IEP for the sixth grade) finally! Special Ed was great - they acted very fast when I emailed them and they realized my son was not getting what he needed in school. My son also has ADHD. He cannot tolerate any of the meds, so right now we only have the IEP - if he didn’t have this IEP he couldn’t cope with middle school.

Unfortunately, unless it is affecting your son’s academic performance (which would most likely mean not performing at grade level), most schools will not give you and IEP or 504 for your child. Our 16 year old (ADD, IQ 133) was only given help because we had a fabulous principal and resource teachers AND he was way off in his writing skills in 2nd grade. I like the suggestion of working with his teacher to get what you think he needs in the classroom. You should also talk to the principal about the best teacher for him, emphasizing that the whole classroom will benefit if he is engaged in his studies and not disruptive.

Under Federal Law to get an IEP it has to be affecting his academic performance or his behavior can be affecting the academic performance of other kids in the class. However, a 504 is for the disability only. Academic performance does not enter into it. The 504 is regulated by the Office of Civil Rights. It’s Federal. For example, you can not refuse to build a ramp for a child in a wheelchair because being in a wheelchair does not affect his academic performance! The 504 is all about accessibility. Giving your ADHD child the same accessibility to the same education as the other kids. This could mean increased time on tests, preferential seating, testing in a distraction free area, more time to turn in assignments, or even decreased homework assignments. If he has co-existing issues (such as with handwriting, etc) that opens up a whole new area for accommodations through Section 504. He can make straight A’s and be in Honors classes and still have a 504 in place. Again, do your research and read the laws for yourself. You can “google” anything. My opinion, again, is to go to http://www.wrightslaw.com.

We have a son with ADHD, inattentive type who is also designated gifted, twice exceptional or GLD. He is now 15 and in grade 10. We switched to an international baccalaureate school school in grade 4. I wish we had done this in grade one! The new school offered him so many more options to expand his learning and they immediately developed an IEP for him. We worked as a team and it made all the difference in the world. If your school is not working with you, move. I wish I had three years earlier. Within one year our son flourished. I wish we were still there. Now we are trying to keep him engaged in grade 10. He is on medication but his sleep is a significant issue but, that’s another story. Best of luck as you advocate for your son to have the learning environment that supports him best.

Dear sleeplessmommy,
I realize that you are still in the initial stages of getting any services at all, so this information may not apply right now. Perhaps it will never be applicable to your situation if sleep apnea is the core issue (as I hope it is, since the “fix” is relatively easy). However, when your gifted child is older he may have uneven skills and will likely be denied access to advanced classes because his study skills or writing skills are not as advanced as most of the students in the Challenge Social Studies or Science class (or whatever). Wright’s Law has a copy of a fantastic letter from the U.S. Office Of Civil Rights about how students cannot be denied access to these classes if they would otherwise qualify for them and cannot be required to forego help in their areas of disability to participate in these classes. I annotated that letter with comments that were specific to my son’s situation and submitted it to my school district along with a letter from me explaining how much I REALLY wanted to avoid taking a legalistic stance and now that they had it in black and white from the Department of Justice that my son is eligible for advanced classes, could we please start figuring out how to make this work for everyone. After that, I didn’t hear another word about how he wasn’t eligible. I still have to be really diligent about making sure he gets the support he needs because schools just aren’t arranged to support 2e students in any kind of automatic way, but there is no more argument about whether or not he belongs in those classes.
Best of luck to you and your son…

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